Information Collection

Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.

IC 179449 under ICR 200704-0960-005 · OMB 0960-0755.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0755 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-525 Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.	Form
SSA-525 Request to Decision Review Board to Vacate the Administr S525.pdf	Form

IC Title:

Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 405.382 20 CFR 405.427

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-525	Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.	S525.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	5,000	5,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.